Diabetes research and clinical practice
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Diabetes Res. Clin. Pract. · Jul 1995
Comparative StudyOval pupil in patients with diabetes mellitus: examination by measurement of the dark-adapted pupillary area and pupillary light reflex.
Determination of the dark-adapted pupillary area (DAPA) by infrared photography revealed that some diabetic patients show corectopia (oval pupil) in addition to the small DAPA as pupillary abnormalities. The prevalence and clinical details of oval pupil were compared between diabetic patients and healthy subjects. Pupillary light reflexes were also analyzed with an infrared videopupillography in some of the diabetic patients. ⋯ Quantitative analysis of pupillary light reflexes with an infrared videopupillography revealed that the dark-adapted pupillary area before photic stimulation (P < 0.01) and the maximum %-velocity of constriction (P < 0.05) were significantly less in the oval pupil group than in the round pupil group. Cranial magnetic resonance imaging revealed no abnormalities in the oval pupil group. From these results, a peripheral autonomic disorder was implicated in the etiology of oval pupils in diabetic patients.
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Rhabdomyolysis (RM) is a clinical and laboratory syndrome resulting from leakage of muscle cell contents into plasma. The increased plasma concentration of the substances released such as creatine kinase (CK) permits the clinician to diagnose this syndrome. Non-traumatic RM has occasionally been reported in patients with diabetic decompensation. ⋯ On admission, those who presented with RM had significantly higher concentration of blood urine nitrogen (BUN) (83.3 +/- 5.9 vs. 58.8 +/- 2.4 mg/dl, P < 0.05), creatine (4.45 +/- 0.4 vs. 2.97 +/- 0.1 mg/dl, P < 0.05) and serum osmolarity (386.5 +/- 5.2 vs. 351.6 +/- 2.4 mOsm/kg, P < 0.05). The mortality within 1 week of diabetic emergencies (38.5% for DKA, 35.5% for HHNK) was higher in patients with RM than those without RM (9.7% for DKA, 26.7% for HHNK). There was a correlation (r = 0.49, P < 0.05) between the levels of serum creatinine and CK in patients with RM.(ABSTRACT TRUNCATED AT 250 WORDS)
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Diabetes Res. Clin. Pract. · Nov 1994
Infrared pupillometry in the assessment of autonomic function.
In order to study normal dynamic pupillary function and to determine reference limits for various pupillary variables, 81 healthy subjects aged between 32 and 60 years were examined using a portable infrared pupillometer. Additionally, 36 patients with type I diabetes mellitus were studied. In healthy subjects, sex had no, or only marginal, effect on the responses. ⋯ The smaller the RRA was, the slower the velocities and the shorter the t75% were. Using these reference limits, 25% of the diabetic patients without cardiac autonomic neuropathy and 50% with definite cardiac autonomic neuropathy had abnormalities in at least one out of four pupillary variables. It is concluded that infrared pupillometry may be a useful additional method for the assessment of autonomic function.
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Diabetes Res. Clin. Pract. · Oct 1994
ReviewSelf-monitoring of blood glucose, as a means of self-management.
In Japan, the study of the self-monitoring of blood glucose (SMBG) was started in 1976. After that, SMBG gradually became popular among the diabetes clinics, and was covered by health insurance in 1987. ⋯ New systems using an electrochemical technology are developing so rapidly that the newest model, with no wiping or blotting of a blood sample, will help the spread of SMBG. We must put emphasis on introducing SMBG as a means of self-management to all patients with diabetes.
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Diabetes Res. Clin. Pract. · Jun 1994
Clinical Trialbeta-Endorphin and some hormonal levels in children with acute stress hyperglycaemia.
The levels of beta-endorphin, insulin, cortisol, GH, glucagon, prolactin and TSH were measured in serum samples of 9 hyperglycaemic patients (3 female, 6 male) with a mean age of 4.1 years admitted to the pediatric emergency unit. All patients were in acute stress due to severe diseases (acute gastroenteritis, bronchopneumonia, septicaemia, etc.). Initial and repeat blood samples for hormone determination were taken at admission and in the recovery phase (after 4-6 weeks of treatment). ⋯ OGTT gave a normal curve. These results indicate that stress hyperglycaemia, despite high insulin levels, is associated with an increase in beta-endorphin levels. The results also show that hyperglycaemia in acute disease does not alter OGTT in short-term follow up.